中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2013年
4期
337-341
,共5页
明帅%王璐%葛增%王岚%周建平%何文生
明帥%王璐%葛增%王嵐%週建平%何文生
명수%왕로%갈증%왕람%주건평%하문생
HIV抗体%HIV单阳家庭%HIV抗体阳转%影响因素
HIV抗體%HIV單暘傢庭%HIV抗體暘轉%影響因素
HIV항체%HIV단양가정%HIV항체양전%영향인소
HIV antibodies%HIV discordant couple%HIV antibodies sero-conversion%Risk factor
目的 了解河南省某市HIV单阳家庭阴性配偶抗体阳转情况及其变化趋势,并探讨其影响因素.方法 以2006年7月起该市管理的经采供血、输血或血制品而感染HIV的单阳家庭阴性配偶共3088名为研究对象,每6个月随访1次至2010年12月,采用ELISA法(初筛试验)和Western blotting法(确认试验)检测其HIV抗体阳转情况；问卷调查收集阴性配偶的人口学信息、行为学信息,并关联当地实验室检测数据库中原阳配偶的血清学信息,分析阴性配偶抗体阳转的影响因素.结果 在3088名研究对象中,132例HIV抗体阳转,总抗体阳转率为1.17/100人年(95％ CI:0.99/100人年～1.39/100人年)；每次随访阳转率中,2008年1-6月阳转率最大(0.82％),2010年1-6月阳转率最小(0.13％),9次随访抗体阳转率呈下降趋势(x2趋势=8.907,P＜0.05)；问卷调查中,男性阴性配偶占56.6％(1513/2673),小学及以下文化程度者占56.2％(1501/2673)；自报最近6个月有过性生活者占81.4％(2176/2673),最近1年性生活频次＜4次/月的占45.7％(1169/2558),坚持使用安全套者占94.5％ (2418/2558)；原阳配偶最近1次CD4+T细胞计数＜200个/μl者占17.4％(437/2505).多因素Cox回归分析发现,阴性配偶为男性(RR=1.58,95％ CI:1.02 ～2.43)、小学及以下文化程度(RR=2.77,95％ CI:1.68 ～4.57)、最近1年有性生活(RR=4.39,95％CI:1.53 ～ 12.56)及原阳配偶最近1次检测CD4+T细胞计数＜ 200个/μl(RR =2.36,95％ CI:1.42～3.93)是阴性配偶抗体阳转的危险因素,而最近1年性生活频次＜4次/月(RR =0.18,95％ CI:0.10～0.32)和坚持使用安全套(RR =0.07,95％ CI:0.05 ～0.12)是阴性配偶抗体阳转的保护因素.结论 该市原阳配偶通过采供血、输血或血制品感染HIV的单阳家庭,其阴性配偶抗体阳转率处于较低水平,且随访阳转率随时间呈下降趋势,这可能与原阳配偶CD4+T细胞计数升高及安全套使用比例较高有关.
目的 瞭解河南省某市HIV單暘傢庭陰性配偶抗體暘轉情況及其變化趨勢,併探討其影響因素.方法 以2006年7月起該市管理的經採供血、輸血或血製品而感染HIV的單暘傢庭陰性配偶共3088名為研究對象,每6箇月隨訪1次至2010年12月,採用ELISA法(初篩試驗)和Western blotting法(確認試驗)檢測其HIV抗體暘轉情況；問捲調查收集陰性配偶的人口學信息、行為學信息,併關聯噹地實驗室檢測數據庫中原暘配偶的血清學信息,分析陰性配偶抗體暘轉的影響因素.結果 在3088名研究對象中,132例HIV抗體暘轉,總抗體暘轉率為1.17/100人年(95％ CI:0.99/100人年～1.39/100人年)；每次隨訪暘轉率中,2008年1-6月暘轉率最大(0.82％),2010年1-6月暘轉率最小(0.13％),9次隨訪抗體暘轉率呈下降趨勢(x2趨勢=8.907,P＜0.05)；問捲調查中,男性陰性配偶佔56.6％(1513/2673),小學及以下文化程度者佔56.2％(1501/2673)；自報最近6箇月有過性生活者佔81.4％(2176/2673),最近1年性生活頻次＜4次/月的佔45.7％(1169/2558),堅持使用安全套者佔94.5％ (2418/2558)；原暘配偶最近1次CD4+T細胞計數＜200箇/μl者佔17.4％(437/2505).多因素Cox迴歸分析髮現,陰性配偶為男性(RR=1.58,95％ CI:1.02 ～2.43)、小學及以下文化程度(RR=2.77,95％ CI:1.68 ～4.57)、最近1年有性生活(RR=4.39,95％CI:1.53 ～ 12.56)及原暘配偶最近1次檢測CD4+T細胞計數＜ 200箇/μl(RR =2.36,95％ CI:1.42～3.93)是陰性配偶抗體暘轉的危險因素,而最近1年性生活頻次＜4次/月(RR =0.18,95％ CI:0.10～0.32)和堅持使用安全套(RR =0.07,95％ CI:0.05 ～0.12)是陰性配偶抗體暘轉的保護因素.結論 該市原暘配偶通過採供血、輸血或血製品感染HIV的單暘傢庭,其陰性配偶抗體暘轉率處于較低水平,且隨訪暘轉率隨時間呈下降趨勢,這可能與原暘配偶CD4+T細胞計數升高及安全套使用比例較高有關.
목적 료해하남성모시HIV단양가정음성배우항체양전정황급기변화추세,병탐토기영향인소.방법 이2006년7월기해시관리적경채공혈、수혈혹혈제품이감염HIV적단양가정음성배우공3088명위연구대상,매6개월수방1차지2010년12월,채용ELISA법(초사시험)화Western blotting법(학인시험)검측기HIV항체양전정황；문권조사수집음성배우적인구학신식、행위학신식,병관련당지실험실검측수거고중원양배우적혈청학신식,분석음성배우항체양전적영향인소.결과 재3088명연구대상중,132례HIV항체양전,총항체양전솔위1.17/100인년(95％ CI:0.99/100인년～1.39/100인년)；매차수방양전솔중,2008년1-6월양전솔최대(0.82％),2010년1-6월양전솔최소(0.13％),9차수방항체양전솔정하강추세(x2추세=8.907,P＜0.05)；문권조사중,남성음성배우점56.6％(1513/2673),소학급이하문화정도자점56.2％(1501/2673)；자보최근6개월유과성생활자점81.4％(2176/2673),최근1년성생활빈차＜4차/월적점45.7％(1169/2558),견지사용안전투자점94.5％ (2418/2558)；원양배우최근1차CD4+T세포계수＜200개/μl자점17.4％(437/2505).다인소Cox회귀분석발현,음성배우위남성(RR=1.58,95％ CI:1.02 ～2.43)、소학급이하문화정도(RR=2.77,95％ CI:1.68 ～4.57)、최근1년유성생활(RR=4.39,95％CI:1.53 ～ 12.56)급원양배우최근1차검측CD4+T세포계수＜ 200개/μl(RR =2.36,95％ CI:1.42～3.93)시음성배우항체양전적위험인소,이최근1년성생활빈차＜4차/월(RR =0.18,95％ CI:0.10～0.32)화견지사용안전투(RR =0.07,95％ CI:0.05 ～0.12)시음성배우항체양전적보호인소.결론 해시원양배우통과채공혈、수혈혹혈제품감염HIV적단양가정,기음성배우항체양전솔처우교저수평,차수방양전솔수시간정하강추세,저가능여원양배우CD4+T세포계수승고급안전투사용비례교고유관.
Objective To understand the overall HIV sero-conversion rate and its trend and risk factors of uninfected partners in sero-discordant couples.Methods A total of 3088 uninfected partners,whose HIV positive partners infected via former plasma donation or blood transfusion from July,2006 to December 2010,were chosen as a fix cohort.They were tested for HIV antibodies twice a year using ELISA by local CDC from July,2006 to December,2010.Data regarding demographic,sexual behavior information of uninfected partners and infection,serologic characteristics of positive partners were retrospectively surveyed and collected to analyze possible risky factors.Results A total of 132 in 3088 uninfected partners were sero-converted,with a sero-conversion rate of 1.17/100 person years (95％ CI:0.99/100 person years-1.39/100 person years).Sero-conversion rate reached the peak (0.82％) in the following interval of January and June in 2008 and have a bottom conversion rate (0.13％) in the same month interval in 2010.Conversion rate outcome showed a downward trend in following (x2trend =8.907,P ＜ 0.05).In the survey,56.6％ (1513/2673) uninfected partners were males,56.2％ (1501/2673) were with lower education level.Among uninfected partners,as reported by themselves,having sex in recently 6 months accounted for a proportion of 81.4％ (2176/2673),sex frequency of less than 4 times per month accounted for 45.7％ (1169/2558) and consistent using of condom accounted for 94.5％ (2418/2558).The proportion of the index partners' most recently CD4 cell count less than 200 cells per μl was 17.4％ (437/2505).Results from multivariate of Cox regression showed that male negative partners(RR =1.58,95％ CI:1.02-2.43),negative partners with lower education level (RR =2.77,95％ CI:1.68-4.57),having sexual activity in latest one year(RR =4.39,95％ CI:1.53-12.56) and CD4 count less than 200 cells per μl(RR=2.36,95％ CI:1.42-3.93) were associated with increased risk of HIV sero-conversion,while intercourse frequency less than 4 times per month (RR =0.18,95％ CI:0.10-0.32),consistent using of condom(RR =0.07,95％ CI:0.05-0.12) decreased the risk of conversion.Conclusion In this city,the conversion rate of negative partners whose positive partner infected via former plasma donation or blood transfusion is relatively low and behave a downward trend.Serologic surveillance,education and intervention based on couple are needed to be enhanced.
